Total atrial conduction time provides novel information in prediction for stroke in patients with sinus rhythm

Area of Science:

• Cardiology
• Neurology
• Medical Imaging

Background:

• Atrial fibrillation (AF) poses a significant stroke risk.
• Echocardiography-derived total atrial conduction time (TACT) is a known predictor of AF.
• Existing stroke risk models may benefit from additional predictive markers.

Purpose of the Study:

• To evaluate if incorporating TACT into the revised Framingham stroke risk profile (rFSRP) improves stroke risk prediction.
• To assess the efficacy of TACT in identifying patients at risk for incident ischemic stroke and new-onset AF.

Main Methods:

• 376 patients without prior stroke or AF underwent echocardiography to measure TACT.
• Patients were followed for 2 years for primary endpoint of ischemic stroke and secondary endpoint of AF.
• Statistical analysis included univariate and multivariate models, and receiver operating characteristic (ROC) curve analysis.

Main Results:

• Longer TACT was significantly associated with increased risk of stroke (169.4 ms vs. 142.7 ms, p < 0.001).
• TACT independently predicted ischemic stroke incidence (HR 1.94 per 10 ms, p < 0.001).
• Adding TACT to rFSRP significantly improved the area under the ROC curve for stroke prediction (0.79 to 0.85, p = 0.001).

Conclusions:

• The addition of TACT to the rFSRP significantly enhances the prediction of stroke incidence in patients without a history of stroke or AF.
• TACT is a valuable, independent predictor of ischemic stroke.
• Further investigation of TACT in large-scale clinical trials is warranted.